免疫组织化学研究流行性出血热肾组织中细胞骨架蛋白和Ⅳ型胶原的改变  

Immunohistochemical study of cytoskeleton and type Ⅳ collagen alterations in the renal tissues from patients with epidemic hemorrhagic fever

作　　者：陈威[1,2] 杨守京[1,2] 刘彦仿[1,2] 李元勋[1,2] 

机构地区：[1]第四军医大学西京医院肾内科 [2]第四军医大学病理学教研室

出　　处：《第四军医大学学报》1997年第3期201-205,共5页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金

摘　　要：目的：研究流行性出血热（ＥＨＦ）尸检肾脏中细胞骨架蛋白和Ⅳ型胶原的变化以客观反映肾脏的损伤．方法：应用免疫组化方法，以抗平滑肌特异性肌动蛋白α链（α－ＳＭａｃｔｉｎ），结蛋白（Ｄｅｓｍｉｎ），波形蛋白（Ｖｉｍｅｎｔｉｎ），Ⅳ型胶原单克隆抗体评价肾小球的损伤；以抗Ⅳ型胶原、Ｖｉｍｅｎｔｉｎ单克隆抗体显示肾小管基底膜、血管和间质的改变；以抗细胞角蛋白（ＣＫ），角蛋白（Ｋｅｒａｔｉｎ），上皮细胞膜抗原（ＥＭＡ）单克隆抗体判断肾小管的损伤；ＰＣＮＡ和Ｖｉｍｅｎｔｉｎ显示肾小管的增生和分化．结果：ＥＨＦ肾脏肾小球固有细胞和基底膜中无显著的Ｄｅｓｍｉｎ，Ｖｉｍｅｎｔｉｎ和Ⅳ型胶原的变化；α－ＳＭａｃｔｉｎ和ＰＣＮＡ可作为增殖性或硬化性肾小球疾病中有用的诊断和判断预后的指标，在ＥＨＦ肾小球中几乎为阴性．在肾髓质严重出血部位，肾小管和血管基底膜的连续性破坏，结构消失，Ⅳ型胶原和Ｖｉｍｅｎｔｉｎ均为阴性，该部位大多数集合管被破坏，ＣＫ，Ｋｅｒａｔｉｎ和ＥＭＡ阳性染色消失．而梗死样坏死部位的肾小管基底膜Ⅳ型胶原染色均匀一致．间质中Ｖｉｍｅｎｔｉｎ，Ⅳ型胶原染色无明显异常．Ｖｉｍｅｎｔｉｎ在上皮细胞中表达是作为细胞增殖分化的标志?Objective: To study the renal lesions indicated by immunohistochemical alteration of cytoskeletal proteins and type Ⅳ collagen in the renal tissues from patients died of epidemic hemorrhagic fever (EHF). Methods: In the present paper, EHF renal tissues derived from autopsy were immunohistochemically researched with MAb to α smooth muscle actin (α SM actin), Desmin, Vimentin and type Ⅳ collagen as indexes of lesions to evaluate glomerular tufts; with MAbs to type Ⅳ collagen and Vimentin for tubular basement membrane, renal vascular and renal interstitial; with MAbs to epithelial membrane antigen and cytokeratin for the renal tubular cells, and with MAbs to PCNA and Vimentin to evaluate the proliferative and differentiation of renal tubular cells. Results: There were no significant alteration of Desmin, Vimentin and type Ⅳ collagen in glomerular resident cells and basement membrane in EHF kidneys; α SM actin and PCNA, might be useful diagnostic and/or prognostic indicators in proliferative or sclerosing glomerular diseases, were almost undetectable in glomerular tufts in EHF kidneys. In the severely hemorregic areas of the medulla, tubular and vascular basement membrane had been destroyed, and Type Ⅳ collagen and Vimentin were negative; most of the collecting tubules were destroyed where the positive staining of Cytokeratin, Keratin and EMA for tubular cells were disappeared; while the type Ⅳ collagen positive tubular basement membrane remained intact in the infarct areas. Vimentin, hence a marker for the state of differentiation, was prominently expressed in the distal and collecting tubules, and found in 9 cases from the patients who died at hypotensive stage of the disease. The tubular regeneration was also proved by the presence of PCNA immunoreactivity. Conclusion: There were no significant alteration of cytoskeletal proteins and type Ⅳ collagen in glomerular tufts in EHF kidneys. The vascular and tubular lesions in EHF were prominent in renal medulla. Other lesions found in EHF kidneys may

关 键 词：流行性出血热 肾脏 细胞骨架 Ⅳ型胶原 免疫组化 

分 类 号：R512.802[医药卫生—内科学]